The official death toll from the cholera outbreak in Zimbabwe has climbed to nearly 500, according to the World Health Organization. But doctors on the ground say the actual fatalities may be closer to 1,000, with more than 12,000 infected since the start of the outbreak in August. Severe shortages of clean water, food, and medicine have allowed the normally treatable illness to ravage the country. Poorer areas have been without running water for months and just this week, the government cut off water to the nation’s capital, Harare. “The country is reaching a catastrophic level, in terms of food, health delivery, education,” said Morgan Tsvangirai, the MDC [opposition party] leader. “Everything seems to be collapsing around us” [Times Online].

Authorities say they have run out of water-purifying chemicals and have therefore shut down the water system in an attempt to contain the waterborne disease. But without running water, sanitation systems are nonexistent and sewage lies in the open air. “Proper hygiene is the best protection against cholera and you can’t do that without clean water,” [BBC News] said Marcus Bachmann of Doctors Without Borders. Residents have resorted to digging shallow wells and using contaminated water despite the government’s warning to use only boiled water. “We are afraid but there is no solution, most of the time the electricity is not available so we just use the water,” resident Naison Chakwicha said [USA Today]. The Health Minister has even asked residents to stop shaking hands. “Although it’s part of our tradition to shake hands, it’s high time people stopped,” he said [CNN].

Cholera is a highly contagious disease caused by a gastrointestinal bacteria infection. Without treatment, it causes acute diarrhea and vomiting within hours and can cause death within days; immediate rehydration therapy and antibiotics can lower the death rate to one percent of infections. But treatment is hard to come by in Zimbabwe, where all major hospitals have closed. “We are receiving up to 15 bodies a day since the cholera outbreak. That is why we have started piling them like that. We cannot cope with the situation,” a hospital official said [CNN]. Cholera cases have already been confirmed in neighboring South Africa, where hundreds of Zimbabweans flee daily to seek treatment.

Cholera outbreaks are not uncommon in Zimbabwe but the country’s current political and economic turmoil has made this outbreak the worst since 1992. The crisis is the latest chapter in the collapse of this once-vibrant nation under President Robert Mugabe, who has ruled for 28 years and refuses to leave office even though he and his party lost elections in March [USA Today].A power-sharing deal between Mugabe and Tsvangirai was reached in September but has not been enforced. The inflation rate for the country’s currency has surpassed 231 million percent.